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HomeMy WebLinkAboutFOLLEN RD 221•Name Address ",\;".H •Lar son 9 P1~outh Road J~dlF~mCU7 Location 221 Fo11enF.oad Service No.'8"1 ?31 Kind of Pipe Size Size of Main Location g-J;; "S"-i'" • Repair-Renewal--New Service Labor j I \ \- ! I ,I Tutal _I Dale I I ~,_L l,'9~~cL 11 32 1\'-- 9 90 II ;I 0- 2 ~~II \I 11 56 -\ ;,25\78,I j!\\ I II ' I II I I II I I Ii I I II I I il I I I (39)\(a.,~ (oIa)I I I I I i I \ I Amount (.!~f" 7!,?g 1/\"2- .:<5Yi" ! DATE-=-:-• F TOWN OF LEXINGTON-BOARD OF PUBLIC WORKS WATER DIVISIO~ >'/ The undersigned applies for a supply of water at No.y)'/1 St.and hereb;'agrees to comply \,ith the rules and regulations as now,or at any future time,established by the Board of Selectmen, / , !'" , ,K"-;....-"Arn't.of Estimate $~0 'Owner Arn't.Paid S _Address Builder _ Sketch of Service Here • Connection rna Remarks: fE~I '.I--,,~I , _'_I 'I I II I-I£:T I .'++t-"!I j-I I I I I I;,1 .r I I 1 I I I I I i "I i I I ." -i T I I !I 'i I i rIl.I...I,I,;1+11 It I ~C'\,l1ir.i..-'.I ,,; 'I .!."1 r-..Th ,i ".! I r I.I Ie ~\'.I ,I , J 'i .'"'I I -A A -I , 1 I ' ,!I iii II :~.1M ,I T I I I I :Ie in Street.~20.0.voiJX!l,mpleted ""'n j ~/,,,,'IX' 19 •